We live in a time of constant exposure to loud sounds. Some of them are completely unexpected and earsplitting, such as last month’s blasts at the Boston Marathon and explosions at the fertilizer plant in West, Texas, or the roadside bombs constantly encountered by military service members overseas.

The newspapers and television media share some of the awful lingering effects for survivors, particularly the physical and psychological trauma. Occasionally the media comment on the disorientation and temporary effects on hearing. But we seldom learn of the long-term effects that many of the survivors experience, especially in relation to hearing loss.

The hearing system is a wonderful and a very delicate tool that allows us to hear a wide range of sounds and words. We take our hearing ability for granted until something occurs to disrupt it. We attend a thunderous rock concert, watch booming 4th of July fireworks or listen to our electronic devices on top volume. Afterward we notice that we are not able to hear clearly for a while. But then our hearing gradually returns to what seems like normal, and we expose ourselves to that same noise again and again. Each time we do this, we increase the likelihood that our hearing will gradually be permanently affected—and we cannot get it back. This deterioration happens because the tiny sensory hair cells of the inner ear get destroyed. These cannot be restored!

Those who happened to near the Boston Marathon bombings were rendered disoriented and unable to hear by the sudden blasts. Some may have found their hearing improving and feeling OK by the next day. But others may now have a noise in their head that is either constant or intermittent—the result of the huge blast their ears were exposed to. These people may find it useful to speak with an audiologist about reducing the effects of this noise on their lives.

Others exposed to the blast may not be able to hear as well as they could before this traumatic event. Their speech may be unclear, or even greatly reduced, and they may hear themselves quite loudly but cannot hear others when they speak. They may wonder at the fact that others next to them have no such permanent effects. All of us are different. And for some reason, some of us can tolerate loud sounds a lot better than others and don’t seem to react as much as others. There is no way to predict at present who can tolerate loud sounds versus who cannot.

What can a person do when there has been a long-term effect on hearing? There are two groups of people who specialize in hearing disorders: Physicians who are ear, nose and throat specialists, and those who are doctors of audiology (audiologists). An audiologist has the training and knowledge to treat hearing disorders, and the physician is trained to treat medical issues related to hearing. Audiologists help those with noise in the ear or hearing loss reduce these effects. Physicians work to repair problems in the ear with medication and surgery.

But a physician’s work may not be enough to solve the problem, and that is when an audiologist may provide the most assistance. The important take-home message is that you do not have to live with deteriorating hearing. Reach out to audiologists and physicians, who can help you continue functioning well in society and access a high quality of life.

James Blair, PhD, CCC-A, is a professor of audiology at Utah State University and an affiliate of ASHA Special Interest Group 8, Public Health Issues Related to Hearing and Balance.

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